1 Application
2 Personal History
3 References
4 Employment History
5 Disclosure
6 Authorization

Office: 406.673.3031 | Fax:406.673.3023 | P.O. Box 470 | 353 Old Hays Rd. | Hays, MT 59527 | www.islandmtn.com

For proper processing all fields of application must be completed.

The following checklist is intended to help you properly complete the process of applying for employment with IMDG. Read this checklist thoroughly before beginning the application.

  • Read the entire Application Checklist 
  • Read the Application for Employment Form Instructions Complete the Application thoroughly. Do not leave anything blank.
  • Complete the Authorization for Background Check and Pre-Employment Drug Screening.
  • Complete the Advisement Regarding False Statements.
  • Carefully review each document for completeness and signature.
  • Enclose copies of requested job advertisement documents and a copy of the following:

A resume may NOT be substituted for any part of the application packet.

If the position for which you are applying for has a filing deadline, your application MUST BE RECEIVED in the Office by 5:00 P.M. on the date of the deadline. Your application will not be considered if IMDG does not receive it by the deadline.

Instructions to the Applicant

  • It is your responsibility to complete this form and provide all required information.
  • You must respond to all items and questions. If a question does not apply to you, write "N/A" (not applicable) in the space provided for your response.


There are very few automatic bases for disqualification. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or convictions are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions may result in your application being rejected, and you disqualified from employment, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals may be disqualified from employment is because the deliberate withholding or misrepresentation of job-relevant information from a prospective employer.

BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.


I have read and understand the above instructions.

Are you a U.S. citizen or legally elligiable to work in the U.S.?
Are you 18 or over?
Are you an Enrolled Member in a Federally Recognized Native American Tribe?
Have you been previously interviewed or employed by the Island Mountain Development Group?
Do you have any relatives currently working for the Island Mountain Development Group?
Are you employed now?
If so, may we contact your present employer?

First Reference

Second Reference

Third Reference


NOTE: You will be required to furnish transcripts to support all of your educational claims.

High School?


Graduate School

Technical Or Certificate Program

Job 1

Job 2

Job 3

This section requires you to report detentions, arrests, and convictions, including diversion programs that were not successfully completed, and in some cases, offenses that may have been pardoned. As an applicant, you are required to disclose this information up to 7 years only, unless specifically exempted by state or federal law. It is strongly recommended that you consult with an attorney before omitting any information.

Please note that a ‘YES’ answer to any of the following questions will not necessarily qualify you from employment. Factors such as the age and time of the offense, seriousness and nature of the violation, and rehabilitation will be considered when making any employment decisions.

Have you ever been convicted of a criminal offense (felony or misdemeanor) in any jurisdiction, for which a pardon has not been granted? (including offenses in the Uniform Code of Military Justice)?
Are you registered as a Violent or Sexual Offender?


I certify that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application., whether on this document or not, may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information. I release all former employers, persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever, if any, for issuing this information.

Notification and Authorization to Release Criminal Justice Information for Employment Purposes

The position for which I am being considered requires me to consent to a criminal background check as a condition of employment. This check includes the following: Criminal history reference searches for felony and misdemeanor convictions at the state and federal levels of every jurisdiction where I currently reside or where I have resided during the past seven ("7") years; and sex offender registry searches at the state and federal levels in every jurisdiction where I currently reside or where I have resided.

I hereby authorize Island Mountain Development Group ("IMDG") to utilize a licensed and/or certified contractor of their choice to conduct the criminal background check described above. In connection with this, I also authorize the use of law enforcement agencies and/or private background check organizations to assist IMDG in collecting this information. I further release IMDG, and any agency, entity, contractor, or organization providing assistance and/or information authorized herein from any claim, cause of action, or liability.

I also am aware that records of arrests on pending charges and/or convictions are not an absolute bar to employment. Such information will be used to determine whether the results of the background check reasonably bear on my trustworthiness or my ability to perform the duties of my position in a manner which is safe for all employees at IMDG.


To the best of my knowledge, the information provided in this Notice and Authorization, my fingerprints and any attachments thereto is true and complete. I understand that any falsification or omission of information may disqualify me for this position and/or may serve as grounds for the severance of my employment with IMDG. By signing below I hereby provide my authorization to IMDG to conduct a criminal background check and I acknowledge that I have been provided with a summary of my rights under the Fair Credit Reporting Act which is attached. In addition to those rights, I understand that I have a right to appeal an adverse employment decision made by IMDG based on my background check information within three business days of receipt of such notice and that a determination on my appeal will be made in seven working days from IMDG's receipt of such appeal.

IMDG is an Equal Opportunity Employer, and except to the extent required by its Native American Preference Policy and Veteran Preference Policy. IMDG prohibits any discrimination because of race, color, religion, sex, pregnancy, age, national origin, citizenship status, veteran status, physical or mental disability, genetic information, political affiliation, or any other basis protected by applicable law. This applies to all employment decisions, including hiring, promotion, termination, and other matters affecting terms and conditions of employment.

Island Mountain Development Group is a drug-free work environment. Pre-employment drug testing may be required. Applicants must consent to a background check.

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if employed, false statements on this application shall be considered sufficient cause of dismissal. You are hereby authorized to make investigation of my personal references.